Prevalence, Predictors, and Consequences of Alcohol Use from Childhood to Midlife

描述（由申请人提供）：基于生命过程发育的观点，本申请建议使用来自三项正在进行的全国代表性出生队列研究（出生于2001年、1970年、1958年;每个n > 10，000）的主要和次要纵向数据，以检查从青春期早期到中年的饮酒的患病率、预测因素和后果。这一发展流行病学应用的具体目标是：（1）通过对2001年千年队列研究（MCS）的11岁调查开始的早期酒精使用和态度进行第一次前瞻性全国性研究，并检验关于儿童气质、认知、家庭对MCS和1970年英国队列研究（BCS）中早期饮酒的影响;（2）在BCS和1958年全国儿童发展研究（NCDS）中，研究工作、家庭、以及成年后的公民社会角色预测了酒精使用和问题饮酒的波动（角色社会化假设），使用固定效应模型来控制稳定的未观察到的效应;和（3）使用倾向评分模型记录酒精使用对中年（BCS/NCDS中38/50岁）健康和社会角色的长期影响。J型关联被假设为轻度至中度饮酒（相对于戒酒和酗酒）预测更大的中年健康和角色成功（后果假设）。针对所有目标的分析将使用多源-父母、教师、医疗、认知、自我报告和多波纵向数据，以控制儿童和青少年的社会和个人资本（选择假设），并测试观察到的效应是否为那些拥有更大资本的人所缓冲（选择x角色社会化，选择x后果假设）。要求提供资金，在11岁MCS调查中增加终生饮酒、使用和酗酒频率、最大数量、积极和消极的酒精预期、感知风险和感知同伴压力的措施，并使用已经收集的从出生到7岁（MCS）、38岁（BCS）和50岁（NCDS）的纵向数据进行二级数据分析。长期而言，该项目旨在跟踪MCS队列到青春期及以后，以及BCS和NCDS队列到成年期（随着关键社会角色的不断变化和酒精使用/滥用后果的积累），以记录人群和亚人群的模式、影响以及对重度和问题饮酒的脆弱性的变化。关于整个生命过程中饮酒模式的前瞻性国家数据，加上对潜在的虚假风险和保护因素以及条件效应的适当控制，对于（a）确定脆弱性的发展前因，（B）了解机制和排除虚假效应，及（c）就以下事项提供资讯及切合发展需要-适当的计划和公共卫生建议，旨在减少酒精滥用和依赖的危害，包括疾病，伤害和社会角色问题。 公共卫生相关性：该项目将提供有关青少年早期饮酒的流行和发展前因以及对饮酒有利和不利的态度的新的和必要的知识，以及关于重度饮酒的长期后果和成年早期至中期的问题。该项目以发展流行病学方法为基础，结合了大规模前瞻性代表性纵向调查研究的优势和尖端纵向方法的优势，以估计整个生命过程中酒精使用的决定因素和后果。这项工作将导致在预防工作中更好地针对人口、年龄组以及风险和保护因素，以推迟发病，减少未成年人饮酒，并减少成年人的酒精滥用和依赖。

DESCRIPTION (provided by applicant): Based on a life course developmental perspective, this application proposes to use primary and secondary longitudinal data from three ongoing nationally representative birth cohort studies (born 2001, 1970, 1958; each n >10,000) to examine prevalence, predictors, and consequences of alcohol use from early adolescence through midlife. Specific aims of this developmental epidemiological application are to: (1) Examine variation in the prevalence of early alcohol initiation by conducting the first prospective national study of early alcohol use and attitudes starting in the age 11 survey of the 2001 Millennium Cohort Study (MCS), and testing theory- based hypotheses about child temperamental, cognitive, and family influences on early alcohol use in the MCS and the 1970 British Cohort Study (BCS) with structural equation models; (2) In the BCS and 1958 National Child Development Study (NCDS), examine how changes in work, family, and civic social roles across adulthood predict fluctuations in alcohol use and problem drinking (Role Socialization hypothesis), using fixed effects models to control for stable unobserved effects; and (3) Document long-term consequences of alcohol use for health and social roles in midlife (age 38/50 in BCS/NCDS) using propensity score models. J-shaped associations are hypothesized in which light-to-moderate alcohol use (relative to abstaining and to heavy drinking) predicts greater midlife health and role success (Consequences hypothesis). Analyses addressing all aims will use multisource-parent, teacher, medical, cognitive, self- report-and multi-wave longitudinal data to control for child and adolescent social and personal capital (Selection hypothesis) and test whether observed effects are buffered for those with greater capital (Selection x Role Socialization, Selection x Consequences hypotheses). Funds are requested to add measures of lifetime alcohol initiation, frequency of use and binge drinking, maximum quantity, positive and negative alcohol expectancies, perceived risk, and perceived peer pressure to age 11 MCS surveys, and to conduct secondary data analyses using already- collected longitudinal data from birth to age 7 (MCS), age 38 (BCS), and age 50 (NCDS). Long- term, the project aims to follow the MCS cohort through adolescence and beyond and the BCS and NCDS cohorts into older adulthood (as pivotal social roles continue to change and alcohol use/abuse consequences accumulate) to document population and sub-population patterns, effects, and variation in vulnerability to heavy and problem drinking. Prospective national data on drinking patterns across the life course, with appropriate controls for potentially spurious risk and protective factors and for conditional effects, are vital for (a) identifying developmental antecedents of vulnerability, (b) understanding mechanisms and ruling out spurious effects, and (c) informing and tailoring developmentally-appropriate programs and public health recommendations designed to decrease harms of alcohol abuse and dependence including disease, injury, and social role problems. PUBLIC HEALTH RELEVANCE: The project will provide new and needed knowledge about the prevalence and developmental antecedents of early adolescent alcohol use and attitudes favorable and unfavorable to use, as well as about the long-term consequences of heavy alcohol use and problems in early to middle adulthood. Based on a developmental epidemiological approach, the project combines the advantages of large scale prospective representative longitudinal survey research with the strengths of cutting-edge longitudinal methods for estimating the determinants and consequences of alcohol use across the life course. The work will lead to better targeting of populations, age groups, and risk and protective factors in preventions aimed at delaying onset, reducing underage drinking, and reducing alcohol abuse and dependence in adulthood.